Can Fentanyl Be Used in Anesthesia?

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Fentanyl has been in the spotlight over the past several years due to the epidemic of overdoses by illicit users. According to the Centers for Disease Control (CDC), 100,000 people died from drug overdose in 2021, and illicit fentanyl was responsible for more than 60% of them.

The powerful opioid properties that make fentanyl so addictive also have practical applications in healthcare. Fentanyl was developed initially as a pain management medication. It is classified as a synthetic opioid and works by blocking the body’s receptors for pain. It is also used as sedation during minor surgical procedures and other medical treatments. Its rapid onset and short duration of action make it ideal for use in anesthesia settings.

Fentanyl anesthesia can be administered through an intravenous, intramuscular, epidural, or intrathecal route (injected into the spine),  depending on the procedure and degree of sedation required. The dose is usually adjusted according to the patient’s level of discomfort or pain sensitivity. It is essential to consider your pre-existing medical conditions before administering fentanyl to reduce the risk of any adverse effects.

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What Are the Effects of Fentanyl as an Anesthetic?

The effects of fentanyl anesthesia depend on the dose administered and individual patient factors. At higher doses, fentanyl can cause unconsciousness in some. Other common side effects of fentanyl include drowsiness, dizziness, nausea/vomiting, constipation, and respiratory depression. These side effects usually resolve within hours of administration; however, they can be more severe if too high of a dose is given or if you have allergies or certain medical conditions.

The use of fentanyl is discouraged if you have any of the following:

  • Surgery in the biliary tract (gallbladder and bile ducts inside and outside the liver) that may slow the process of fentanyl passing out of the liver.
  • Slow respiration or obstructive airway diseases like asthma, COPD, obstructive sleep apnea, obesity hypoventilation (breathing at an abnormally slow rate due to obesity and causing a build-up of carbon dioxide in the blood).
  • Liver failure.
  • A known intolerance to fentanyl, codeine, or other morphine-like drugs or their ingredients.
  • Known hypersensitivity to non-active ingredients used in the drug’s delivery, such as sodium chloride or sodium hydroxide.
  • You should always discuss your health history and any allergies you may have with your physician before starting treatment with fentanyl.

Is Fentanyl Safe for Conscious Sedation?

Conscious sedation is a form of anesthesia that allows you to remain awake and responsive throughout the procedure. It is typically used for minor procedures, such as dental work or endoscopies, that require only mild to moderate levels of sedation. When fentanyl is used for conscious sedation, it is usually administered in lower doses than what would be used for general anesthesia and typically provides a deeper level of sedation than other medications.

The side effects mentioned above are still possible with its use; however, they may not be as severe as higher doses of fentanyl. The quantity should be adjusted according to your level of discomfort or pain sensitivity to reduce the risk of serious side effects. Careful monitoring during the procedure is also necessary to ensure your safety.

Is Fentanyl Used in General Anesthesia?

Fentanyl is commonly used for general anesthesia in many procedures. It is usually administered intravenously and provides rapid onset of action with few side effects. As with any anesthetic agent, there are potential risks associated with using fentanyl for general anesthesia, including hypotension and respiratory depression. Careful monitoring during the procedure is necessary to ensure your safety.

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How Much Fentanyl is Administered for Sedation?

The amount of fentanyl administered for sedation depends on your age, weight, and level of pain sensitivity. Generally, lower doses are used for conscious sedation than what would be used for general anesthesia. The dose should always be adjusted according to the individual’s needs to minimize the risk of serious side effects.

Fentanyl Use During Oral Surgery

Its rapid onset makes fentanyl an ideal anesthetic for oral surgery. It is usually administered intravenously. As with any anesthetic agent, there are potential risks associated with using fentanyl for oral surgery, including hypotension and respiratory depression.

How Long Does Fentanyl Keep You Sedated?

How long you remain sedated with fentanyl will depend on several factors, including the dose, route of administration, and individual patient characteristics. Generally, intravenous fentanyl has a short-acting duration (usually up to 4 hours) as an analgesic and a longer-acting duration (up to 12 hours) for conscious sedation or general anesthesia.

When administered intramuscularly, the onset of action is usually 7-8 minutes, with effects lasting 1-2 hours. Lower doses are typically used than required for general anesthesia during conscious sedation to reduce the risk of side effects. The slowed respiration caused by fentanyl may last longer than the sedative effects.

Can Fentanyl Used for Anesthesia Cause Dependence?

Fentanyl is a powerful opioid pain medication that can be habit-forming and lead to dependence. Because of its potency, fentanyl and other opioid analgesics have a high potential for misuse, giving rise to new clinical practice guidelines in prescribing them. When used as an analgesic, it is typically prescribed as a short-term solution while other forms of treatment are explored. However, when used for general anesthesia or conscious sedation, it is essential to note that long-term use may increase the risk of addiction.

There is also potential for developing dependence if fentanyl is taken in higher than recommended doses or by individuals who have not been prescribed fentanyl. Careful monitoring during the procedure and proper usage according to doctor’s instructions is necessary to reduce these risks.

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While fentanyl has many medical applications, including as anesthesia, using it recreationally can quickly lead to an addiction that is hard to shake. It’s important to remember that recovery is possible and that choosing the right addiction treatment center for you is essential to long-term recovery. At Guardian Recovery, we provide comprehensive treatment, including medically-assisted detox, therapy, specialty programs, and reintegration support. Our caring and experienced administrative, medical, and clinical teams will guide you through every step of your recovery process from the first time you call. We provide a complimentary assessment and a free insurance benefits check and help coordinate local travel to our facility. All you or your loved one has to do is ask for help; we will take care of the rest. Contact us today.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/016619s034lbl.pdf
  2. https://clinicaltrials.gov/ct2/show/NCT02558569
  3. https://pubs.asahq.org/anesthesiology/article/90/2/576/37742/A-Review-of-the-Use-of-Fentanyl-Analgesia-in-the
  4. https://www.ncbi.nlm.nih.gov/books/NBK459275/
  5. https://www.oooojournal.net/article/0030-4220(72)90226-5/fulltext

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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